Frozen shoulder
(Part 1)
Overview
Frozen shoulder, also called adhesive capsulitis, involves stiffness and pain in the shoulder joint. Signs and symptoms typically begin slowly, then get worse. Over time, symptoms get better, usually within 1 to 3 years.
Having to keep a shoulder still for a long period increases the risk of developing frozen shoulder. This might happen after having surgery or breaking an arm.
Treatment for frozen shoulder involves range-of-motion exercises. Sometimes treatment involves corticosteroids and numbing medications injected into the joint. Rarely, arthroscopic surgery is needed to loosen the joint capsule so that it can move more freely.
It’s unusual for frozen shoulder to recur in the same shoulder. But some people can develop it in the other shoulder, usually within five years
Symptoms
Frozen shoulder typically develops slowly in three stages.
∙ Freezing stage. Any movement of the shoulder causes pain, and the shoulder’s ability to move becomes limited. This stage lasts from 2 to 9 months.
∙ Frozen stage. Pain might lessen during this stage. However, the shoulder becomes stiffer. Using it becomes more difficult. This stage lasts from 4 to 12 months.
∙ Thawing stage. The shoulder’s ability to move begins to improve. This stage lasts from 5 to 24 months.
For some people, the pain worsens at night, sometimes disrupting sleep.
What is the main cause of frozen shoulder (adhesive capsulitis)?
Researchers don’t know exactly why frozen shoulder develops. The condition occurs when inflammation causes your shoulder joint capsule to thicken and tighten. Thick bands of scar tissue called adhesions develop over time, and you have less synovial fluid to keep your shoulder joint lubricated. This makes it more difficult for your shoulder to move and rotate properly.
Who’s at risk for developing frozen shoulder?
The following risk factors increase your likelihood of developing frozen shoulder:
∙ Age: Frozen shoulder most commonly affects adults between the ages of 40 and 60 years old.
∙ Sex: The condition affects females more often than males
∙ Recent shoulder injury: Any shoulder injury or surgery that results in the need to keep your shoulder from moving (for example, by using a shoulder brace, sling, shoulder wrap, etc.) increases your risk of frozen shoulder. Examples include a rotator cuff tear and fractures of your shoulder blade, collarbone or upper arm.
∙ Diabetes: Between 10% and 20% of people with diabetes develop frozen shoulder.
∙ Other health diseases and conditions: This includes stroke, hypothyroidism (underactive thyroid gland), hyperthyroidism (overactive thyroid gland), Parkinson’s disease and heart disease. Stroke is a risk factor for frozen shoulder because movement of your arm and shoulder may be limited. Researchers aren’t sure why other diseases and conditions increase the risk of developing frozen shoulder. (To be continued)